Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou, 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, 510515, China; Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China.
Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China.
Clin Nutr. 2021 May;40(5):2868-2875. doi: 10.1016/j.clnu.2021.04.004. Epub 2021 Apr 18.
BACKGROUND & AIMS: The prospective relation of dietary vitamin A intake with hypertension remains uncertain. We aimed to investigate the relationship of dietary vitamin A intake with new-onset hypertension and examine possible effect modifiers in general population.
This prospective cohort study included 12,245 participants who were free of hypertension at baseline from China Health and Nutrition Survey (CHNS). Dietary intake was measured by 3 consecutive 24-h dietary recalls combined with a household food inventory. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or diagnosed by physician or under antihypertensive treatment during the follow-up.
During a median follow-up duration of 6.1 years, a total of 4,304 (35.1%) participants developed new-onset hypertension. Overall, there was an L-shaped relation of total dietary vitamin A intake with new-onset hypertension (P for nonlinearity <0.001). Accordingly, compared with participants with lower vitamin A intake (quartile 1, <227.3 μg RE/day), those with higher vitamin A intake (quartile 2-4, ≥227.3 μg RE/day) had a significantly lower risk of new-onset hypertension (adjusted HR, 0.73; 95%CI: 0.63, 0.78). Similar results were found for plant-derived vitamin A intake (adjusted HR, 0.65; 95% CI, 0.61, 0.70) or animal-derived vitamin A intake (adjusted HR, 0.76; 95% CI, 0.70, 0.82).
There was a L-shaped relation of dietary vitamin A intake with new-onset hypertension in general Chinese adults. Our results emphasized the importance of maintaining relatively higher vitamin A intake levels for the prevention of hypertension.
饮食中维生素 A 摄入量与高血压之间的前瞻性关系尚不确定。我们旨在研究饮食中维生素 A 摄入量与新发高血压之间的关系，并在一般人群中检查可能的效应修饰因子。
本前瞻性队列研究纳入了来自中国健康与营养调查（CHNS）的 12245 名基线时无高血压的参与者。饮食摄入量通过 3 次连续 24 小时饮食回忆和家庭食物库存相结合进行测量。研究结果为新发高血压，定义为收缩压≥140mmHg 和/或舒张压≥90mmHg，或在随访期间由医生诊断或正在接受降压治疗。
在中位随访 6.1 年期间，共有 4304 名（35.1%）参与者发生新发高血压。总的来说，总饮食维生素 A 摄入量与新发高血压之间存在 L 型关系（非线性 P<0.001）。因此，与维生素 A 摄入量较低的参与者（第 1 四分位数，<227.3μgRE/天）相比，维生素 A 摄入量较高的参与者（第 2-4 四分位数，≥227.3μgRE/天）发生新发高血压的风险显著降低（调整后的 HR，0.73；95%CI：0.63，0.78）。植物来源的维生素 A 摄入量（调整后的 HR，0.65；95%CI，0.61，0.70）或动物来源的维生素 A 摄入量（调整后的 HR，0.76；95%CI，0.70，0.82）也得到了类似的结果。
在一般中国成年人中，饮食中维生素 A 摄入量与新发高血压之间存在 L 型关系。我们的研究结果强调了保持相对较高的维生素 A 摄入量水平对预防高血压的重要性。
